中药在抑制补体活性及溶血反应中的作用
摘要
补体是免疫系统的重要组成部分,补体过度激活可引起炎症反应、组织损伤及各类免疫性溶血反应。临床上常见的溶血反应多为新生儿溶血及血型不合溶血性输血反应,两者均由补体活化介导红细胞破坏而发生溶血,且危害较大。目前,溶血性输血反应及新生儿溶血病的治疗主要应用免疫抑制剂等药物,虽起效快,但具有一定毒副作用。然而,我国中药资源丰富,应用理论博大精深,若能以中药抑制补体活性,采用中西医结合输血,溶血性疾病的防治将会更加安全有效。因此,本文将对部分已知中药在抑制补体活性及减轻溶血反应中的作用作一综述,以期全面了解中药在补体抑制剂研发及溶血性疾病防治中的潜在应用价值。
引文
1 Varela J C, Tomlinson S. Complement:an overview for the clinician[J].Hematol Oncol Clin North Am,2015, 29(3):409-427.
2 Uhlmann E J, Shenoy S, Goodnough L T. Successful treatment of recurrent hyperhemolysis syndrome with immunosuppression and plasma-to-red blood cell exchange transfusion[J].Trans fusion, 2014, 54(2):384-388.
3 Yang L, Ren C, Mao M, et al. Prognostic factors of the efficacy of high-dose corticosteroid therapy in hemolysis, elevated liver enzymes, and low platelet count syndrome during pregnancy:a meta-analysis[J].Medicine(Baltimore),2016, 95(13):e3203.
4 Zwiers C, Scheffer-Rath M E, Lopriore E, et al.Immunoglobulin for alloimmune hemolytic disease inneonates[J].Cochrane Database Syst Rev, 2018, 3:CD003313.
5 Delaney M, Wendel S, Bercovitz R S, et al.Transfusion reactions:prevention, diagnosis, and treatment[J].Lancet, 2016, 388(10061):2825-2836.
6 Koshy R, Patel B, Harrison J S.Anti-Kpa-induced severe delayed hemolytic transfusion reaction[J].Immunohematology, 2009, 25(2):44-47.
7 Ainsworth C D, Crowther M A, Treleaven D, et al.Severe hemolytic anemia post-renal transplantation produced by donor anti-D passenger lymphocytes:case report and literature review[J]. Trans Med Rev,2009, 23(2):155-159.
8 XIE W, DU L. Diabetes is an inflammatory disease:Evidence from traditional Chinese medicines[J].Diabetes ObesMetab, 2011, 13(4):289-301.
9 Emmens R W, Wouters D, Zeerleder S, et al. On the value of therapeutic interventions targeting the complement system in acute myocardial infarction[J].Transl Res, 2017, 182:103-122.
10 Robertson J J, Brem E, Koyfman A.The acute hemolytic anemias:The importance of emergency diagnosis and management[J]. J Emerg Med, 2017, 53(2):202-211.
11 Berentsen S. Complement activation and inhibition in autoimmune hemolytic anemia:Focus on cold agglutinin disease[J].Semin Hematol, 2018, 55(3):141-149.
12 Risitano A M, Notaro R, Marando L, et al.Complement fraction 3 binding on erythrocytes as additional mechanism of disease in paroxysmal nocturnal hemoglobinuria patients treated by eculizumab[J].Blood, 2009, 113(17):4094-4100.
13 Lauritsch-Hernandez L S, Kraehenmann F, Balabanov S. Eculizumab application during pregnancy in a patient with paroxysmal nocturnal hemoglobinuria:A case report with review of the literature[J]. Clin Case Rep,2018, 6(8):1582-1587.
14 Harder M J, Kuhn N, Schrezenmeier H, et al.Incomplete inhibition by eculizumab:mechanistic evidence for residual C5 activity during strong complement activation[J]. Blood, 2017, 129(8):970-980.
15吴彦,吴甘霖.半枝莲多糖抗补体活性研究[J].中国实验方剂学杂志, 2009, 15(05):49-52.
16崔昊,孙黔云,杨娟.刺梨多糖的抗补体活性研究[J].贵阳中医学院学报, 2009, 31(01):22-24.
17付丽娜,陈兰英,刘荣华,等.白茅根的化学成分及其抗补体活性[J].中药材,2010, 33(12):73-75.
18张学俊,伊廷金,孙黔云.杜仲叶多糖的提取分离、抗补体活性及结构研究[J].天然产物研究与开发,2011, 23(6):606-611.
19张英,周光雄.广藿香的本草考证研究[J].中药材,2015, 38(09):1986-1989.
20阮姝楠,卢燕,陈道峰.广藿香的抗补体活性成分[J].中国中药杂志,2013, 38(13):2129-2135.
21 Jin J H, Cheng Z H, Chen D F. Anti-complement constituents of commelinacommunis and their targets in complement activation cascade[J]. Journal of Chinese Pharmaceutical Sciences, 2012, 21(1):577-581.
22焦杨,邹录惠,邱莉,等.5种马鞭草科药用植物的抗补体活性[J].中国药科大学学报,2016, 47(04):469-473.
23侯灵莉,李松林,闫银萍,等.香椿果抗补体活性成分[J].中国实验方剂学杂志,2017, 23(21):52-58.
24朱芳娟,侯灵莉,孙黔云,等.叶下珠抗补体活性研究[J].中国药理学通报,2018, 34(05):686-690.
25张卫,黄璐琦,李超霞,等.金银花品种的本草考证[J].中国中药杂志,2014, 39(12):2239-2245.
26倪付勇,刘露,宋亚玲,等.金银花中抗补体活性酚酸类成分的研究[J].中国中药杂志,2015, 40(02):269-274.
27李平,胡建燃,史宝忠.潞党参多糖的抗补体活性分析[J].生命科学研究,2018,22(02):136-142.
28 Adatya S, John R, Eckman P M.Treatment of hemolysis with intravenous unfractionated heparin using an antifactor Xa-based monitoring protocol[J]. J Thorac Cardiovasc Surg, 2015, 149(5):1465-1466.
29 Ferguson D, Kovach A E.Rasburicase-induced hemolytic anemia in previously undiagnosed G6PD deficiency[J].Blood, 2018, 132(6):673.
30朱红艳,金华,杨庆莉,等.新生儿ABO溶血病的早期诊断及治疗[J].中国卫生产业,2014, 18(9):151-152.
31 Abdul-Aziz B, Lorencatto F, Stanworth S J, et al.Patients'and health care professionals'perceptions of blood trans fusion:a systematic re vie w[J].Transfusion, 2018, 58(2):446-455.
32林静霞,任俊,肖帆,等.输血不良反应的临床特点及影响因素分析[J].中国输血杂志,2015, 28(03):291-294.
33兰炯采,刘志伟,丁志山,等.创建中西医结合中国特色输血医学体系[J].中国输血杂志,2017, 30(08):855-858.
34 Weinstock C, Mohle R, Dorn C, et al. Successful use of eculizumab for treatment of an acute hemolyticreaction after ABO-incompatible red blood cell transfusion[J]. Trans fusion, 2015, 55(3):605-610.
35曹锦花.茵陈的化学成分和药理作用研究进展[J].沈阳药科大学学报,2013,30(06):489-494.
36缪频,朱桂莲.中药治疗ABO溶血临床疗效观察[J].中华中医药学刊,2016,34(03):757-759.
37俞丽平.中药预防母婴血型不合溶血病临床观察[J].新中医,2013, 45(08):115-116.
38李莉华,张静,马印图,等.茵栀黄口服液早期干预治疗Rh血型不合新生儿溶血病临床观察[J].河北医药,2013, 35(22):3383-3385.
39梁洁.茵陈蒿汤联合维生素C治疗IgG抗体高效价孕妇预防新生儿溶血病的临床观察[J].中国临床新医学,2016, 9(10):873-875.
40黄洁,孙荃荟.中药治疗母儿ABO血型不合系统评价[J].中医药导报,2015,21(02):55-59.
2 Uhlmann E J, Shenoy S, Goodnough L T. Successful treatment of recurrent hyperhemolysis syndrome with immunosuppression and plasma-to-red blood cell exchange transfusion[J].Trans fusion, 2014, 54(2):384-388.
3 Yang L, Ren C, Mao M, et al. Prognostic factors of the efficacy of high-dose corticosteroid therapy in hemolysis, elevated liver enzymes, and low platelet count syndrome during pregnancy:a meta-analysis[J].Medicine(Baltimore),2016, 95(13):e3203.
4 Zwiers C, Scheffer-Rath M E, Lopriore E, et al.Immunoglobulin for alloimmune hemolytic disease inneonates[J].Cochrane Database Syst Rev, 2018, 3:CD003313.
5 Delaney M, Wendel S, Bercovitz R S, et al.Transfusion reactions:prevention, diagnosis, and treatment[J].Lancet, 2016, 388(10061):2825-2836.
6 Koshy R, Patel B, Harrison J S.Anti-Kpa-induced severe delayed hemolytic transfusion reaction[J].Immunohematology, 2009, 25(2):44-47.
7 Ainsworth C D, Crowther M A, Treleaven D, et al.Severe hemolytic anemia post-renal transplantation produced by donor anti-D passenger lymphocytes:case report and literature review[J]. Trans Med Rev,2009, 23(2):155-159.
8 XIE W, DU L. Diabetes is an inflammatory disease:Evidence from traditional Chinese medicines[J].Diabetes ObesMetab, 2011, 13(4):289-301.
9 Emmens R W, Wouters D, Zeerleder S, et al. On the value of therapeutic interventions targeting the complement system in acute myocardial infarction[J].Transl Res, 2017, 182:103-122.
10 Robertson J J, Brem E, Koyfman A.The acute hemolytic anemias:The importance of emergency diagnosis and management[J]. J Emerg Med, 2017, 53(2):202-211.
11 Berentsen S. Complement activation and inhibition in autoimmune hemolytic anemia:Focus on cold agglutinin disease[J].Semin Hematol, 2018, 55(3):141-149.
12 Risitano A M, Notaro R, Marando L, et al.Complement fraction 3 binding on erythrocytes as additional mechanism of disease in paroxysmal nocturnal hemoglobinuria patients treated by eculizumab[J].Blood, 2009, 113(17):4094-4100.
13 Lauritsch-Hernandez L S, Kraehenmann F, Balabanov S. Eculizumab application during pregnancy in a patient with paroxysmal nocturnal hemoglobinuria:A case report with review of the literature[J]. Clin Case Rep,2018, 6(8):1582-1587.
14 Harder M J, Kuhn N, Schrezenmeier H, et al.Incomplete inhibition by eculizumab:mechanistic evidence for residual C5 activity during strong complement activation[J]. Blood, 2017, 129(8):970-980.
15吴彦,吴甘霖.半枝莲多糖抗补体活性研究[J].中国实验方剂学杂志, 2009, 15(05):49-52.
16崔昊,孙黔云,杨娟.刺梨多糖的抗补体活性研究[J].贵阳中医学院学报, 2009, 31(01):22-24.
17付丽娜,陈兰英,刘荣华,等.白茅根的化学成分及其抗补体活性[J].中药材,2010, 33(12):73-75.
18张学俊,伊廷金,孙黔云.杜仲叶多糖的提取分离、抗补体活性及结构研究[J].天然产物研究与开发,2011, 23(6):606-611.
19张英,周光雄.广藿香的本草考证研究[J].中药材,2015, 38(09):1986-1989.
20阮姝楠,卢燕,陈道峰.广藿香的抗补体活性成分[J].中国中药杂志,2013, 38(13):2129-2135.
21 Jin J H, Cheng Z H, Chen D F. Anti-complement constituents of commelinacommunis and their targets in complement activation cascade[J]. Journal of Chinese Pharmaceutical Sciences, 2012, 21(1):577-581.
22焦杨,邹录惠,邱莉,等.5种马鞭草科药用植物的抗补体活性[J].中国药科大学学报,2016, 47(04):469-473.
23侯灵莉,李松林,闫银萍,等.香椿果抗补体活性成分[J].中国实验方剂学杂志,2017, 23(21):52-58.
24朱芳娟,侯灵莉,孙黔云,等.叶下珠抗补体活性研究[J].中国药理学通报,2018, 34(05):686-690.
25张卫,黄璐琦,李超霞,等.金银花品种的本草考证[J].中国中药杂志,2014, 39(12):2239-2245.
26倪付勇,刘露,宋亚玲,等.金银花中抗补体活性酚酸类成分的研究[J].中国中药杂志,2015, 40(02):269-274.
27李平,胡建燃,史宝忠.潞党参多糖的抗补体活性分析[J].生命科学研究,2018,22(02):136-142.
28 Adatya S, John R, Eckman P M.Treatment of hemolysis with intravenous unfractionated heparin using an antifactor Xa-based monitoring protocol[J]. J Thorac Cardiovasc Surg, 2015, 149(5):1465-1466.
29 Ferguson D, Kovach A E.Rasburicase-induced hemolytic anemia in previously undiagnosed G6PD deficiency[J].Blood, 2018, 132(6):673.
30朱红艳,金华,杨庆莉,等.新生儿ABO溶血病的早期诊断及治疗[J].中国卫生产业,2014, 18(9):151-152.
31 Abdul-Aziz B, Lorencatto F, Stanworth S J, et al.Patients'and health care professionals'perceptions of blood trans fusion:a systematic re vie w[J].Transfusion, 2018, 58(2):446-455.
32林静霞,任俊,肖帆,等.输血不良反应的临床特点及影响因素分析[J].中国输血杂志,2015, 28(03):291-294.
33兰炯采,刘志伟,丁志山,等.创建中西医结合中国特色输血医学体系[J].中国输血杂志,2017, 30(08):855-858.
34 Weinstock C, Mohle R, Dorn C, et al. Successful use of eculizumab for treatment of an acute hemolyticreaction after ABO-incompatible red blood cell transfusion[J]. Trans fusion, 2015, 55(3):605-610.
35曹锦花.茵陈的化学成分和药理作用研究进展[J].沈阳药科大学学报,2013,30(06):489-494.
36缪频,朱桂莲.中药治疗ABO溶血临床疗效观察[J].中华中医药学刊,2016,34(03):757-759.
37俞丽平.中药预防母婴血型不合溶血病临床观察[J].新中医,2013, 45(08):115-116.
38李莉华,张静,马印图,等.茵栀黄口服液早期干预治疗Rh血型不合新生儿溶血病临床观察[J].河北医药,2013, 35(22):3383-3385.
39梁洁.茵陈蒿汤联合维生素C治疗IgG抗体高效价孕妇预防新生儿溶血病的临床观察[J].中国临床新医学,2016, 9(10):873-875.
40黄洁,孙荃荟.中药治疗母儿ABO血型不合系统评价[J].中医药导报,2015,21(02):55-59.